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Fields marked
* are compulsory. Personal details provided here will only be used for the purpose of enrolment and communication concerning
the Summer Institute programmes. If you have any questions about this form or the admission procedure, please contact us at summer-info-gsss@uva.nl .

Personal data

Surname *

Please write your name as it is written
in your passport

Given/First names *

Initials*

Provide the initial of only your first
and middle names

Date of birth*

City of birth*

Country of birth*

Nationality*

Sex (male/female)*

We apologize that we can only provide
two options for sex. Unfortunately the software only accepts the options of male or female.

Male
Female

Contact Information

E-mail*

This should also be an email you can
be reached at throughout and following the programme.

E-mail check*

Telephone country code
*

Telephone number *

Excluding country code and symbols (-#!.)

House/apartment number*

number only

Street Address*

Additional address identifiers

Example: Room C, Floor 4, Apt D

(Example: Room C, Floor 4, Apt D)

Postal Code *

Without spaces; If you do not have a
postcode, please put 0.

City*

Country*

Emergency Contact

We will use this information ONLY in the event of a personal
emergency.

Emergency contact*

Name (& relationship)

Emergency phone*

Phone number including country code

Emergency e-mail*

GSSS_emergency_contact_email

Current / most recent higher education

Please indicate the most recent or relevant
institution you attended.

Institute*

City*

Country*

From*

GSSS_vooropleiding_datum_start

To (expected) (dd-mm-yyyy)

Study programme*

Subsidiary subjects

Degree

English proficiency

This summer course is taught in English. An
English proficiency test is not required, but students are expected to have the ability to read academic English texts, follow
lectures in English, and to participate in discussions conducted in English.

Knowledge of English in speaking*

Native
Good
Adequate
Poor

Knowledge of English in reading*

Native
Good
Adequate
Poor

How many years have you taken formal English classes?*

Other questions

How did you hear about the programme?*

I read about it in a newspaper/newsletterI followed a link on a website about summer coursesI heard about it from a previous student of the Summer ProgrammesI heard about it on Facebook, Twitter, LinkedIn, or InstagramI heard about it from a professorI heard about it from the study abroad office of my university

Name of the newspaper/newsletter*

Website URL*

Name of the Professor*

How are you going to finance this programme?*

Self-fundedScholarship

I applied for the following scholarship*

The scholarship has been granted*

Yes
No
Unknown

Do you wish to apply for housing?*

Yes, I would like to apply for housingNo, I will arrange my own accommodation

Are there any medical dietary needs we should be aware of?

Do you have any mobility needs (eg wheelchair access)?

Documents

Upload the following
documents now:

Photo*

Upload a recent photo of yourself.

Initializing Upload...

Passport*

Upload a scan of the identity page of
your passport. If you do not have a passport yet, please upload a scan of your identity card or driver's licence.

Upload a transcript from your most recent/relevant
higher educational institute that you have attended before enrolment in the summer programme, listing all grades and credits
obtained.

Initializing Upload...

Motivation*

State in about 350 words your commitment
to the field of study of the summer programme and describe your previous academic experience in this field. Then explain why
you wish to participate and what you hope to learn.

Initializing Upload...

Reference Letter & Application fee

In order for your application to be marked "Complete," you must submit the following:

Letter of Reference
One letter of reference by a qualified person (professor, employer). To be sent by e-mail directly from the
referee to summer-info-gsss@uva.nl,
clearly mentioning your full name.

Application
feeThe application fee is € 25. Within one week after you submit
the application, you will receive instructions on how to complete the payment. Applicants
for the NUFFIC/KOP/MSP scholarship are not required to pay an application fee.

Name of referee*

Job title of referee*

Remarks

Declaration

I hereby declare that all information
in this application is truthful. I authorise the Graduate School of Social Sciences to verify my educational and professional
credentials.

Yes*

CHECK AND SUBMIT

Please check your details before you submit your form.

SUMMER INSTITUTE 2018

academicYear:27798

Personal data

Surname *

Please write your name as it is written
in your passport

im030000_itembank_9525:27701

Given/First names *

im030000_itembank_9526:27702

Initials*

Provide the initial of only your first
and middle names

im030000_itembank_10782:27724

Date of birth*

dateOfBirth:27725

City of birth*

cityOfBirth:27726

Country of birth*

countryOfBirth:27727

Nationality*

nationality:27728

Sex (male/female)*

We apologize that we can only provide
two options for sex. Unfortunately the software only accepts the options of male or female.

sex:27729

Contact Information

E-mail*

This should also be an email you can
be reached at throughout and following the programme.

email:27731

E-mail check*

emailCheck:27732

Telephone country code
*

im030000_itembank_10783:27733

Telephone number *

Excluding country code and symbols (-#!.)

im030000_itembank_10784:27734

House/apartment number*

number only

im030000_itembank_10786:27735

Street Address*

im030000_itembank_10785:27737

Additional address identifiers

Example: Room C, Floor 4, Apt D

im030000_itembank_10787:27736

Postal Code *

Without spaces; If you do not have a
postcode, please put 0.

im030000_itembank_10788:27738

City*

im030000_itembank_2110:27739

Country*

residenceCountry:27740

Emergency Contact

Emergency contact*

Name (& relationship)

e7a6612682de33e7f9e35c3887c0f21d:27741

Emergency phone*

Phone number including country code

fb961e58dc7862b672bec9258d2a7762:27742

Emergency e-mail*

f6bd0bb4e8abe4b1dd5e688affef3447:27743

Current / most recent higher education

Institute*

im030000_itembank_4531:27748

City*

5bd1182cf9604fe799bc94b9f7ea5a3d:27749

Country*

im030000_itembank_2772:27750

From*

15afa0a21c75da7111b9b2bc671addac:27751

To (expected) (dd-mm-yyyy)

im030000_itembank_4581:27752

Study programme*

im030000_itembank_4529:27753

Subsidiary subjects

0abd681038b8b4efb97a057310b30884:27754

Degree

4c23539665145548c4eb51dcc5136436:27755

English proficiency

Knowledge of English in speaking*

e15aa6fc1d25a60384815ba01d698ab9:27756

Knowledge of English in reading*

7a8043aea085e50226e5893719eee168:27757

How many years have you taken formal English classes?*

60f7c33bc7c8cabb530b26db027836d0:27758

Other questions

How did you hear about the programme?*

im030000_itembank_10797:27760

Name of the newspaper/newsletter*

im030000_itembank_10806:27762

Website URL*

im030000_itembank_10808:27763

Name of the Professor*

im030000_itembank_10809:27765

How are you going to finance this programme?*

im030000_itembank_12822:29936

I applied for the following scholarship*

im030000_itembank_12842:29937

The scholarship has been granted*

im030000_itembank_12843:29938

Do you wish to apply for housing?*

8f9a3378f0a62933a7cd1a7e531fba8b:27769

Are there any medical dietary needs we should be aware of?

im030000_itembank_9528:27770

Do you have any mobility needs (eg wheelchair access)?

2798fa3734e431a26d3bc1f3e698cd26:27771

Documents

Photo*

Upload a recent photo of yourself.

im030000_itembank_12882:30066

Initializing Upload...

Passport*

Upload a scan of the identity page of
your passport. If you do not have a passport yet, please upload a scan of your identity card or driver's licence.

Upload a transcript from your most recent/relevant
higher educational institute that you have attended before enrolment in the summer programme, listing all grades and credits
obtained.

im030000_itembank_4603:27775

Initializing Upload...

Motivation*

State in about 350 words your commitment
to the field of study of the summer programme and describe your previous academic experience in this field. Then explain why
you wish to participate and what you hope to learn.

You have submitted your form. Please note that your submission is only successful once
you receive the confirmation email in your email inbox. If you did not receive the confirmation email in your inbox, please
email summer-info-gsss@uva.nl immediately.

SUMMER INSTITUTE 2018

Personal data

Surname *

Please write your name as it is written
in your passport

Given/First names *

Initials*

Provide the initial of only your first
and middle names

Date of birth*

City of birth*

Country of birth*

Nationality*

Sex (male/female)*

We apologize that we can only provide
two options for sex. Unfortunately the software only accepts the options of male or female.

Contact Information

E-mail*

This should also be an email you can
be reached at throughout and following the programme.

E-mail check*

Telephone country code
*

Telephone number *

Excluding country code and symbols (-#!.)

House/apartment number*

number only

Street Address*

Additional address identifiers

Example: Room C, Floor 4, Apt D

Postal Code *

Without spaces; If you do not have a
postcode, please put 0.

City*

Country*

Emergency Contact

Emergency contact*

Name (& relationship)

Emergency phone*

Phone number including country code

Emergency e-mail*

Current / most recent higher education

Institute*

City*

Country*

From*

To (expected) (dd-mm-yyyy)

Study programme*

Subsidiary subjects

Degree

English proficiency

Knowledge of English in speaking*

Knowledge of English in reading*

How many years have you taken formal English classes?*

Other questions

How did you hear about the programme?*

Name of the newspaper/newsletter*

Website URL*

Name of the Professor*

How are you going to finance this programme?*

I applied for the following scholarship*

The scholarship has been granted*

Do you wish to apply for housing?*

Are there any medical dietary needs we should be aware of?

Do you have any mobility needs (eg wheelchair access)?

Documents

Photo*

Upload a recent photo of yourself.

Initializing Upload...

Passport*

Upload a scan of the identity page of
your passport. If you do not have a passport yet, please upload a scan of your identity card or driver's licence.

Upload a transcript from your most recent/relevant
higher educational institute that you have attended before enrolment in the summer programme, listing all grades and credits
obtained.

Initializing Upload...

Motivation*

State in about 350 words your commitment
to the field of study of the summer programme and describe your previous academic experience in this field. Then explain why
you wish to participate and what you hope to learn.